As I sit here and write this, I can't believe that my little walnut is ONE whole month old! where has the time gone? I just can't quite fathom that she is a month old. Maybe becasue she is still so little or the craziness of the last few months it just all feels surreal. As of today she is 32 weeks. And she is just growing like crazy! She's gained over a pound in the last month!
So since we are still in the NICU this won't be my traditional monthly post, but I will try my best to sort of summarize our last month here in the NICU.
So since birth Lorelai has made a lot of progress! Giving birth to her and Laynie at 27 weeks 5 days, was by far the scariest day of my life. As I've well documented in their birth story.
At birth Lorelai came out guns blazing determined to prove everyone wrong, that a small yet mighty little girl had made her way into this world. For starters she NEVER had to be ventilated! This is huge for a "micro preemie". Most babies (sorry I don't know the actual statistics) some sort of breathing assistance when born this prematurly. This is usually in the form of CPAP or being intubated and made to breath on a ventilator. Luckily for us and for Lorelai she never required the ventilation. She only was ventilated for a short period of time a few hours after birth just so they could give her some surfactant which is used to help her lungs mature. The reason she had to be ventilated for this was because this was the only way to get the medication to her. As soon as they administered it she was taken right back off of it. --She's a champ for sure.
She stayed on the CPAP for a little over 2 weeks. She was on a pretty high setting of the CPAP, but was able to come down gradually. Then at about 2 weeks old she was brought down to what they call Vapotherm. This is a specific type of nasal cannula. This nasal cannula has more flow going through it. so it allows her to still breath on her own but allows her lungs to remain open still. She remained on that as well for about a week or so before coming down to a normal nasal cannula which she remains at now. The only thing left for her breathing wise is to bring her down to nothing. We are in no rush to do this and will just sort of trial it when the doctors feel she is ready. She is currently on 1L of flow with a little bit of humidity to help to not dry out her nose too much. She continues to have the occasional desat (drop in oxygen) and occasional brady (drop on heart rate). and once these become fewer and fewer we will start to wein her down to no oxygen support.
Along with the breathing support she has made great strides in her eating too. Being born so young, she doesn't have the normal refexes to eat like a term baby. To give her the nutrition she needs they feed her through an OG tube that goes in her mouth and into her stomach and via TPN which is IV nutrition. When she was first born they were giving her more IV nutrtion than through the tube. They had to be slow in introducing the feedings of breastmilk through the tube becasue they didn't want to overload her gut too soon which can cause infection called NEC which can be deadly. So the first few weeks she was given her IV nutrition as they slowly increased the feedings she was getting through her OG tube.
The feedings they gave her through her OG tube started at 2mls every 3 hours, and gradually increased to 4, 7, 10, 13, 17,18, 22, 24, and now she is on 26mls of breastmilk every 3 hours. Once she finally got to "full feeds" which was 18 mls they discontinued her IV nutrition. They also began to fortify her OG feeds with additional calories to help her gain weight. Due to her small size she requires a little more calories than the term baby in order to gain weight. Her body is also working harder to breath and do the things that come easier for term babies. So as of right now she is on 24 cal feeds.
We had only a few hiccups with her. The first hiccup we had with her was a "complication" that happens often with preemie babies. She had a large PDA. which is a normal connection in the heart that is there in utero that allows blood to be shunted away from the lungs while they are still inside the mother since the oxygenation of the blood is done by the placenta. Once a term baby is born their bodys get the signal that this connection needs to close. But due to her being premature her body didn't get this memo. She was given one course of a medication that helped to close this connection and she has been doing well ever since.
The second "complication" was that she had a low blood volume once and required a little bit of supplemental blood. This is a "normal" complication due to the fact that they are taking blood from the babies and they aren't able to replenish it quite as fast. A small drop of blood can be a big deal for them.
Overall this little warrior amazes me everyday with her strength and progress. She is acting just like a premature baby should. This month has been tough, coming to the NICU 2-3 times a day for me, while balancing the time at home with the boys. But I wouldn't trade my time with her for anything. She is so precious and I'm so grateful to God for giving much a beautiful little girl who has touched so many people and allowed me to be a positive inspiration in so many lives. She will be here for at least another month, and with all her accomplishments this month, I can't wait to see what next month brings us.
Lorelai, you amaze me everyday. Your daddy and I love you so much! Keep it up baby girl. Keep getting stronger so we can have you home with us soon. Your brothers can't wait to meet you!!!
